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What Causes Positve Urine Test For Oxycodone And Ativan?
Question: My life partner is in a nursing home. When I went to see her last Sunday she was non-responsive, having long period of apnea. I had to shake her by the shoulders to get her to open 1 eye. She has no sedation ordered. The initial urine test came back positive for oxycodone and ativan. No other drugs showed up in her urine. They tell me it will take 5-10 days to gt the final results. Can you tell me if there is anyother reason for these 2 drugs to be in her system, other than she was given them? She has Alzheimer's.
Brief Answer:
Drug screen could be false positive.
Detailed Answer:
Hi,
I am Dr. Prakash HM and I would like to answer your query.
Patients with Alzheimers will be under lots of medications.
I do not have the list of medications, but with this limited knowledge I can tell you as follows -It could be a case of false positive (Test is positive, but no drug from that class is present) for reasons mentioned below
1. Many drugs get metabolized differently in different people. eg: Person taking sertaline or oxaprozin could be positive for benzodiazapines (Lorazepam belongs to the group), Hydrocodone could test positive for oxycodone
2. Due to method used like EIA (enzyme linked immuno assay to test for antibodies against suspected drug/metabolite)- cross reactivity to antibodies can cause false positive results even to common cardiac medications or antibiotics
3.Patients with lactic acidosis (cases of diabetes mellitus, liver disease) can give false positive result.
Standard urine tests can give plenty of false positives, so only confirmatory tests with Gas chromatography - mass spectrometry (GC-MS) are done.
Numerous cases of false positive are seen (4-50%) depending on various tests.
All drug screen requires confirmation before any decision is taken.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Drug screen could be false positive.
Detailed Answer:
Hi,
I am Dr. Prakash HM and I would like to answer your query.
Patients with Alzheimers will be under lots of medications.
I do not have the list of medications, but with this limited knowledge I can tell you as follows -It could be a case of false positive (Test is positive, but no drug from that class is present) for reasons mentioned below
1. Many drugs get metabolized differently in different people. eg: Person taking sertaline or oxaprozin could be positive for benzodiazapines (Lorazepam belongs to the group), Hydrocodone could test positive for oxycodone
2. Due to method used like EIA (enzyme linked immuno assay to test for antibodies against suspected drug/metabolite)- cross reactivity to antibodies can cause false positive results even to common cardiac medications or antibiotics
3.Patients with lactic acidosis (cases of diabetes mellitus, liver disease) can give false positive result.
Standard urine tests can give plenty of false positives, so only confirmatory tests with Gas chromatography - mass spectrometry (GC-MS) are done.
Numerous cases of false positive are seen (4-50%) depending on various tests.
All drug screen requires confirmation before any decision is taken.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
meds she is on:
amiodarone, tenormin, synthroid, galatamine, quinapril, fluoxetine. Considering the meds that she is on, the fact that there is no order for either oxycodone or ativan and the symptoms she exhibited, how can you have oxycodone and ativan show in her urine? Do any of these drugs breakdown to oxycodone and/or ativan that would appear in a urine tox screen?
amiodarone, tenormin, synthroid, galatamine, quinapril, fluoxetine. Considering the meds that she is on, the fact that there is no order for either oxycodone or ativan and the symptoms she exhibited, how can you have oxycodone and ativan show in her urine? Do any of these drugs breakdown to oxycodone and/or ativan that would appear in a urine tox screen?
Brief Answer:
Fluoxetine could cause ativan positive
Detailed Answer:
Hi,
It is highly unpredictable to tell which drug could be positive unless a specific study of each drug is done.
Each body metabolizes different drug differently, so any drug could be positive.
However, I did not find any evidence related to synthroid, galantamine or quinapril
Few things, I did find out are
1. Fluoxetine and Sertraline both function as selective serotonin reuptake inhibitors - Sertraline is proved to give false positive for benzodiazepines group (ativan belongs to it) - So Fluoxetine could have given the false positive reaction
2. Amiodarone as drug is known to interact with immunoassay test for drug screen. So false positives can occur.
3. Fluoxetine is known to interact with methadone (similar to oxycodone) and increase its half life - However, no evidence of positive drug screen exists.
4. Fluoxetine is known to give false positive for amphetamines and LSD
5. Tenormin is known to give false positive for amphetamines.
As numerous reactions occur inside the human body, it is virtually difficult to substantiate everything. I think we need to wait for further tests for confirmation.
Hope it helps
Dr. Prakash HM
Fluoxetine could cause ativan positive
Detailed Answer:
Hi,
It is highly unpredictable to tell which drug could be positive unless a specific study of each drug is done.
Each body metabolizes different drug differently, so any drug could be positive.
However, I did not find any evidence related to synthroid, galantamine or quinapril
Few things, I did find out are
1. Fluoxetine and Sertraline both function as selective serotonin reuptake inhibitors - Sertraline is proved to give false positive for benzodiazepines group (ativan belongs to it) - So Fluoxetine could have given the false positive reaction
2. Amiodarone as drug is known to interact with immunoassay test for drug screen. So false positives can occur.
3. Fluoxetine is known to interact with methadone (similar to oxycodone) and increase its half life - However, no evidence of positive drug screen exists.
4. Fluoxetine is known to give false positive for amphetamines and LSD
5. Tenormin is known to give false positive for amphetamines.
As numerous reactions occur inside the human body, it is virtually difficult to substantiate everything. I think we need to wait for further tests for confirmation.
Hope it helps
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Raju A.T
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