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One Step Amphetamine Test Device Package Insert
A rapid, one step test for the qualitative detection of Amphetamines in human urine.
For healthcare professionals including professionals at point of care sites
For professional in vitro diagnostic use only.
The AMP One Step Amphetamine Test Device is a lateral flow chromatographic immunoassay for the detection of Amphetamines in human urine. This assay provides only a preliminary analytical test result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are used.
Amphetamine is a Schedule II controlled substance available by presecription (Dexedrine®) and is also available on the illicit market. Amphetamines are a class of potent sympathomimetic agents with therapeutic applications. They are chemically related to the human body’s natural catecholamines: epinephrine and norepinephrine. Acute higher does lead to enhanced stimulation of the central nervous system and induce euphoria, alertness, reduced appetite, and a sense of increased energy and power. Cardiovascular responses to Amphetamines include increased blood pressure and cardiac arrhythmias. More acute responses produce anxiety, paranoia, hallucinations, and psychotic behavior. The effects of Amphetamines generally last 2-4 hours following use, and the drug has a half-life of 4-24 hours in the body. About 30% of Amphetamines are excreted in the urine in unchanged form, with the remainder as hydroxylated and deaminated derivatives. The AMP One Step Amphetamine Test Device is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of Amphetamines in urine. The AMP One Step Amphetamine Test Device yields a positive result when Amphetamines in urine exceed 1,000 ng/mL.
The AMP One Step Amphetamine Test Device is a rapid chromatographic immunoassay based on the principle of competitive binding. Drugs which may be present in the urine specimen compete against the drug conjugate for binding sites on the antibody. During testing, a urine specimen migrates upward by capillary action. Amphetamines, if present in the urine specimen below 1,000 ng/mL, will not saturate the binding sites of the antibody coated particles in the test device. The antibody- coated particles will then be captured by immobilized Amphetamine conjugate and a visible colored line will show up in the test line region. The colored line will not form in the test line region if the Amphetamine level exceeds 1,000 ng/mL because it will saturate all the binding sites of anti-Amphetamine antibodies. A drug-positive urine specimen will not generate a colored line in the test line region because of drug competition, while a drug-negative urine specimen or a specimen containing a drug concentration less than the cut-off will generate a
line in the test line region. To serve as a procedural control, a colored line will always appear at the control line region, indicating that proper volume of specimen has been added and membrane wicking has occurred.
The test device contains mouse monoclonal anti-Amphetamine antibodycoupled particles and Amphetamine-protein conjugate. A goat antibody is employed in the control line system.
For healthcare professionals including professionals at point of care sites. For in vitro diagnostic use only. Do not use after the expiration date. The test device should remain in the sealed pouch until use. All specimens should be considered potentially hazardous and handled in the same manner as an infectious agent. The used test device should be discarded according to federal, state and local regulations.
STORAGE AND STABILITY
Store as packaged in the sealed pouch at 2-30°C. The test device is stable through the expiration date printed on the sealed pouch. The test device must remain in the sealed pouch until use. DO NOT FREEZE. Do not use beyond the expiration date.
SPECIMEN COLLECTION AND PREPARATION
Urine Assay The urine specimen must be collected in a clean and dry container. Urine collected at any time of the day may be used. Urine specimens exhibiting visible particles should be centrifuged, filtered, or allowed to settle to obtain clear specimen for testing.
Specimen Storage Urine specimens may be stored at 2-8°C for up to 48 hours prior to assay. For long-term storage, specimens may be frozen and stored below -20°C. Frozen specimens should be thawed and mixed before testing.
Materials Provided Test devices Disposable specimen droppers Package insert Materials Required But Not Provided Specimen collection container Timer External controls DIRECTIONS FOR USE Allow the test device, urine specimen, and/or controls to reach room temperature (15-30 Cº ) prior to testing. 1. Bring the pouch to room temperature before opening it. Remove the test device from the sealed pouch and use it as soon as possible. 2. Place the test device on a clean and level surface. Hold the dropper vertically and transfer 3 full drops of urine (approx. 100l) to the specimen well (S) of the test device, and then start the timer. Avoid trapping air bubbles in the specimen well (S). See the illustration below. 3. Wait for the colored line(s) to appear. The result should be read at 5 minutes. Do not interpret the result after 10 minutes.
INTERPRETATION OF RESULTS (Please refer to the illustration above)
NEGATIVE:* Two lines appear. One colored line should be in the control region (C), and another apparent colored line should be in the test region (T). This negative result indicates that the Amphetamine concentration is below the detectable level (1,000 ng/mL). * NOTE: The shade of color in the test line region (T) will vary, but it should always be considered as negative whenever there is even a faint line.
POSITIVE: One colored line appears in the control region (C). No line appears in the test region (T). This positive result indicates that the Amphetamine concentration exceeds the detectable level (1,000 ng/mL).
INVALID: Control line fails to appear. Insufficient specimen volume or incorrect procedural techniques are the most likely reasons for control line failure. Review the procedure and repeat the test using a new test device. If the problem persists, discontinue using the lot immediately and contact your local distributor.
A procedural control is included in the test. A colored line appearing in the control region (C) is considered an internal procedural control. It confirms sufficient specimen volume, adequate membrane wicking and correct procedural technique.
Control standards are not supplied with this kit; however it is recommended that positive and negative controls be tested as good laboratory practice to confirm the test procedure and to verify proper test performance.
1. The AMP One Step Amphetamine Test Device provides only a qualitative, preliminary analytical result. A secondary analytical method must be used to obtain a confirmed result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method. 1,2 2. It is possible that technical or procedural errors, as well as other interfering substances in the urine specimen may cause erroneous results. 3. Adulterants, such as bleach and/or alum, in urine specimens may produce erroneous results regardless of the analytical method used. If adulteration is suspected, the test should be repeated with another urine specimen. 4. A Positive Result does not indicate level or intoxication, administration route or concentration in urine. 5. A Negative Result may not necessarily indicate drug-free urine. Negative results can be obtained when drug is present but below the cutoff level of the test. 6. Test does not distinguish between drugs of abuse and certain medications.
Accuracy A side-by-side comparison was conducted using the AMP One Step
Amphetamine Test Device and a leading commercially available AMP rapid test. Testing was performed on 300 clinical specimens. Ten percent of the specimens employed were either at –25% or +25% level of the cut-off concentration of 1,000 ng/mL Amphetamine. Presumptive positive results were confirmed by GC/MS. The following results were tabulated: Method Other AMP Rapid Test Total Results AMP One Step Test Device Results Positive Negative Positive 140 0 140 Negative 6 154 160 Total Results 146 154 300 % Agreement with this commercial kit 96% >99% 98% When compared at 1,000 ng/mL cut-off with GC/MS, the following results were tabulated: Method GC/MS Total Results AMP One Step Test Device Results Positive Negative Positive 131 9 140 Negative 5 155 160 Total Results 136 164 300 % Agreement with GC/MS Analysis 96% 95% 95% Eighty (80) of these samples were also run using the AMP One Step Amphetamine Test Device by an untrained operator at a different site. Based on GC/MS data, the operator obtained a statistically similar Positive Agreement, Negative Agreement and Overall Agreement rate as the laboratory personnel.
Analytical Sensitivity A drug-free urine pool was spiked with Amphetamine at the following concentrations: 0 ng/mL, 500 ng/mL, 750 ng/mL, 1,000 ng/mL, 1,250 ng/mL and 1,500 ng/mL. The result demonstrates >99% accuracy at 50% above and 50% below the cut-off concentration. The data are summarized below: AMP Concentration (ng/mL) Percent of Cutoff n Visual Result Negative Positive 0 0% 30 30 0 500 -50% 30 30 0 750 -25% 30 23 7 1,000 Cutoff 30 9 21 1,250 +25% 30 1 29 1,500 +50% 30 0 30
Analytical Specificity The following table lists compounds that are positively detected in urine by the AMP One Step Amphetamine Test Device at 5 minutes. Compound Concentration (ng/mL) d-Amphetamine 1,000 d,l-Amphetamine sulfate 3,000 l-Amphetamine 50,000 () 3,4-Methylenedioxyamphetamine 2,000 Phentermine 3,000
Precision A study was conducted at 3 physician’s offices by untrained operators using 3 different lots of product to demonstrate the within run, between run and between operator precision. An identical panel of coded specimens containing no Amphetamine, 25% Amphetamine above and below the cut-off and 50% Amphetamine above and below the 1,000 ng/mL cut-off was provided to each site. Amphetamine n Site A Site B Site C concentration (ng/mL) - + - + - + 0 15 15 0 15 0 15 0 500 15 14 1 13 2 15 0 750 15 11 4 7 8 5 10 1,250 15 2 13 0 15 1 14 1,500 15 1 14 1 14 1 14
Effect of Urinary Specific Gravity
Fifteen (15) urine samples of normal, high, and low specific gravity ranges were spiked with 500 ng/mL and 1,500 ng/mL of Amphetamine respectively. The AMP One Step Amphetamine Test Device was tested in duplicate using the fifteen neat and spiked urine samples. The results demonstrate that varying ranges of urinary specific gravity does not affect the test results.
Effect of the Urinary pH
The pH of an aliquoted negative urine pool was adjusted to a pH range of 5 to 9 in 1 pH unit increments and spiked with Amphetamine to 500 ng/mL and 1,500 ng/mL. The spiked, pH-adjusted urine was tested with the AMP One Step Amphetamine Test Device in duplicate. The results demonstrate that varying ranges of pH does not interfere with the performance of the test. Cross-Reactivity
A study was conducted to determine the cross-reactivity of the test with compounds in either drug-free urine or Amphetamine positive urine. The following compounds show no cross-reactivity when tested with the AMP One Step Amphetamine Test Device at a concentration of 100 g/mL.
Non Cross-Reacting Compounds 4-Acetamidophenol Estrone-3-sulfate Oxolinic acid Acetophenetidin Ethyl-p-aminobenzoate Oxycodone N-Acetylprocainamide Fenfluramine Oxymetazoline Acetylsalicylic acid Fenoprofen Papaverine Aminopyrine Furosemide Penicillin-G Amitryptyline Gentisic acid Pentazocine Amobarbital Hemoglobin Pentobarbital Amoxicillin Hydralazine Perphenazine Ampicillin Hydrochlorothiazide Phencyclidine Ascorbic acid Hydrocodone Phenelzine Apomorphine Hydrocortisone Phenobarbital Aspartame p-Hydroxyamphetamine l-Phenylephrine Atropine O-Hydroxyhippuric acid -Phenylethlamine Benzilic acid p-Hydroxymethamphetamine Phenylpropanolamine Benzoic acid Prednisolone Benzoylecgonine 3-Hydroxytyramine Prednisone Benzphetamine Ibuprofen Procaine Bilirubin Imipramine Promazine Brompheniramine (-) Isoproterenol Promethazine Caffeine Isoxsuprine d,l-Propanolol Cannabidiol Ketamine d-Propoxyphene Cannabinol Ketoprofen d-Pseudoephedrine Chloralhydrate Labetalol Quinidine Chloramphenicol Levorphanol Quinine Chlordiazepoxide Loperamide Ranitidine Chlorothiazide Maprotiline Salicylic acid () Chlorpheniramine Meperidine Secobarbital Chlorpromazine Meprobamate Serotonin (5Hydroxytyramine) Chlorquine Methadone Cholesterol d-methamphetamine Sulfamethazine Clomipramine (l)-methamphetamine Sulindac Clonidine Methoxyphenamine Temazepam Cocaine hydrochloride 3,4-Methylenedioxyethylamphetamine Tetracycline Codeine Tetrahydrocortisone, 3 Acetate Cortisone (+) 3,4-Methylenedioxymethamphetamine ( -) Cotinine Tetrahydrocortisone 3 (-D glucuronide) Creatinine Methylphenidate Deoxycorticosterone Morphine-3--Dglucuronide Tetrahydrozoline Dextromethorphan Thebaine Diazepam Nalidixic acid Thiamine Diclofenac Naloxone Thioridazine Diflunisal Naltrexone Tolbutamine Digoxin Naproxen Triamterene Diphenhydramine Niacinamide Trifluoperazine Doxylamine Nifedipine Trimethoprim Ecgonine hydrochloride Norcodein Trimipramine Ecgonine methylester Norethindrone d,l-Tryptophan (IR,2S)-(-)-Ephedrine d-Norpropoxyphene Tyramine l-Ephedrine Noscapine d,l-Tyrosine (-) Y Ephedrine d,l-Octopamine Uric acid Erythromycin Oxalic acid Verapamil -Estradiol Oxazepam Zomepirac
1. Baselt RC. Disposition of Toxic Drugs and Chemicals in Man. 2nd Ed. Biomedical Publ., Davis, CA. 1982; 488 2. Hawwks RL, CN Chiang. Urine Testing for Drugs of Abuse. National Institute for Drug Abuse (NIDA), Research Monograph 73, 1986
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