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What Does My Lab Test Report Indicate?
Question: I need a toxicologist to interpret a drug test showing norhydrocodne
Brief Answer:
I'm a pharmacologist with a background in addiction medicine....
Detailed Answer:
First depends a bit on the type of test... the dipstick ones are about as good as you'd expect (not very). The mass spect are very good... but that is a breakdown product of narcotics and the overall pattern would include MORE than just that....
so... a bit more info ?
I'm a pharmacologist with a background in addiction medicine....
Detailed Answer:
First depends a bit on the type of test... the dipstick ones are about as good as you'd expect (not very). The mass spect are very good... but that is a breakdown product of narcotics and the overall pattern would include MORE than just that....
so... a bit more info ?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have uploaded the most recent lab report.
I take the following in addition to the meds on the report
Toprol xl 100 mg 1 x daily
Phenergan 25 mg, as needed, do not take very often
The tech at the pain management center stated Norhydrocodone could only be produced by taking a Hydrocodone medicine and is not a result of the codeine breaking down into hydrocodone and the hydrocodone breaking down into norhydrocodone.
I have requested a DNA test to determine how medication is broken down in my system.
Any reference material you could direct me to would be greatly appreciated.
I take the following in addition to the meds on the report
Toprol xl 100 mg 1 x daily
Phenergan 25 mg, as needed, do not take very often
The tech at the pain management center stated Norhydrocodone could only be produced by taking a Hydrocodone medicine and is not a result of the codeine breaking down into hydrocodone and the hydrocodone breaking down into norhydrocodone.
I have requested a DNA test to determine how medication is broken down in my system.
Any reference material you could direct me to would be greatly appreciated.
Brief Answer:
yeah, I see where the tech is coming from; it is not that certain.
Detailed Answer:
"Since norhydrocodone is a major metabolite of hydrocodone only, the detection of this specific metabolite may be helpful in confirming hydrocodone use."
http://www.ncbi.YYYY.gov/YYYY/0000
http://www.ncbi.YYYY.gov/pmc/articles/YYYY0000/
basically, this is the literature that supports what the technician is saying.
Ok, so you know already what the pathways are:
hydrocodone to norhydrocodone
codeine, to a small amount of hydrocodone also morphine and norcodeine
It would be a bit helpful to know the dosing. Assuming the drugs are being taken regularly without days of skipping, then one would assume the levels would be .. well... leveled off. One would expect a fair amount of all metabolites and drugs that are taken to be there.
So.......
A lot of codeine, but it looks like not very much of hydrocodone (1 to 2% of the amount of codeine) and a higher amount of norhydrocodone but far less than the amount of codeine. Norhydrocodone I strongly suspect hangs around longer than hydrocodone... so.... a small amount of hydrocodone being produced all the time would build up the norhydrocodone.
Cannot totally distinguish last dose of hydrocodone 2 days prior to testing versus NO hydrocodone being taken but a small amount of hydrocodone being made from codeine over time and a build up of norhydrocodone.
Although the article IMPLIES that a decent amount of norhydrocodone means hydrocodone was being taken, there is zero proof of this assertion in the literature. A tiny tiny amt of hydrocodone with a higher amount of norhydrocodone but very small compared to the level of codeine would imply the codeine is being broken down at the 1-2% level to hydrocodone and that this could account for the amt of norhydrocodeine that was seen, but the literature doesn't do a good job of finding out the particulars of norhydrocodone.
yeah, I see where the tech is coming from; it is not that certain.
Detailed Answer:
"Since norhydrocodone is a major metabolite of hydrocodone only, the detection of this specific metabolite may be helpful in confirming hydrocodone use."
http://www.ncbi.YYYY.gov/YYYY/0000
http://www.ncbi.YYYY.gov/pmc/articles/YYYY0000/
basically, this is the literature that supports what the technician is saying.
Ok, so you know already what the pathways are:
hydrocodone to norhydrocodone
codeine, to a small amount of hydrocodone also morphine and norcodeine
It would be a bit helpful to know the dosing. Assuming the drugs are being taken regularly without days of skipping, then one would assume the levels would be .. well... leveled off. One would expect a fair amount of all metabolites and drugs that are taken to be there.
So.......
A lot of codeine, but it looks like not very much of hydrocodone (1 to 2% of the amount of codeine) and a higher amount of norhydrocodone but far less than the amount of codeine. Norhydrocodone I strongly suspect hangs around longer than hydrocodone... so.... a small amount of hydrocodone being produced all the time would build up the norhydrocodone.
Cannot totally distinguish last dose of hydrocodone 2 days prior to testing versus NO hydrocodone being taken but a small amount of hydrocodone being made from codeine over time and a build up of norhydrocodone.
Although the article IMPLIES that a decent amount of norhydrocodone means hydrocodone was being taken, there is zero proof of this assertion in the literature. A tiny tiny amt of hydrocodone with a higher amount of norhydrocodone but very small compared to the level of codeine would imply the codeine is being broken down at the 1-2% level to hydrocodone and that this could account for the amt of norhydrocodeine that was seen, but the literature doesn't do a good job of finding out the particulars of norhydrocodone.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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