FirstStep Drug Screen Test Card

The FirstStep Drug Screen Test Card is for testing of any combination of Amphetamine, Barbiturates, Benzodiazepines, Cocaine, Methamphetamine, Morphine, Methadone, Phencyclidine and Marijuana.

FirstStep's One Step Drug Screen Test Card is a rapid, one step screening test for the simultaneous, qualitative detection of multiple drugs and drug metabolites in human urine. For healthcare professionals including professionals at point of care sites. For in vitro diagnostic use only.

INTENDED USE

The FirstStep Drug Screen Test Card is a lateral flow chromatographic immunoassay for the qualitative detection of multiple drugs and drug metabolites in urine at the following cut- off concentrations:

The configurations of the One Step Multi- Drug Screen Test Card come with any combination of the above listed drug analytes. 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.

<< back to top

SUMMARY OF INDIVIDUAL DRUGS

Amphetamine: Amphetamine is a Schedule II controlled substance available by prescription (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 Strip 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 Amphetamine in urine. The AMP One Step Amphetamine Test Strip yields a positive result when Amphetamines in urine exceed 1,000 ng/ mL.      >>back to top

Barbiturates: Barbiturates are central nervous system depressants. They are used therapeutically as sedatives, hypnotics, and anticonvulsants. Barbiturates are almost always taken orally as capsules or tablets. The effects resemble those of intoxication with alcohol. Chronic use of barbiturates leads to tolerance and physical dependence. Short acting Barbiturates taken at 400 mg/ day for 2- 3 months produces a clinically significant degree of physical dependence. Withdrawal symptoms experienced during periods of drug abstinence can be severe enough to cause death. Only a small amount (less than 5%) of most Barbiturates are excreted unaltered in the urine. The approximate detection time limits for Barbiturates are:

The BAR One Step Barbiturates Test Strip 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 Barbiturates in urine. The BAR One Step Barbiturates Test Strip yields a positive result when the Barbiturates in urine exceed the cut- off level.      >>back to top

Benzodiazepines: Benzodiazepines are medications that are frequently prescribed for the symptomatic treatment of anxiety and sleep disorders. They produce their effects via specific receptors involving a neurochemical called gamma aminobutyric acid (GABA). Because they are safer and more effective, Benzodiazepines have replaced barbiturates in the treatment of both anxiety and insomnia. Benzodiazepines are also used as sedatives before some surgical and medical procedures, and for the treatment of seizure disorders and alcohol withdrawal. Risk of physical dependence increases if Benzodiazepines are taken regularly (e. g., daily) for more than a few months, especially at higher than normal doses. Stopping abruptly can bring on such symptoms as trouble sleeping, gastrointestinal upset, feeling unwell, loss of appetite, sweating, trembling, weakness, anxiety and changes in perception. Only trace amounts (less than 1%) of most Benzodiazepines are excreted unaltered in the urine; most of the concentration in urine is conjugated drug. The detection period for the Benzodiazepines in the urine is 3- 7 days. The BZO One Step Benzodiazepines Test Strip is a rapid urine- screening test that can be performed without the use of an instrument. The test utilizes the antibody to selectively detect elevated levels of Benzodiazepines in urine. The BZO One Step Benzodiazepines Test Strip yields a positive result when the Benzodiazepines in urine exceeds cut- off concentration.      >>back to top

Cocaine: Cocaine is a potent central nervous system (CNS) stimulant and a local anesthetic. Initially, it brings about extreme energy and restlessness while gradually resulting in tremors, over- sensitivity and spasms. In large amounts, cocaine causes fever, unresponsiveness, and difficulty in breathing and unconsciousness. Cocaine is often self- administered by nasal inhalation, intravenous injection and free- base smoking. It is excreted in the urine in a short time primarily as Benzoylecgonine 1,2 . Benzoylecgonine, a major metabolite of cocaine, has a longer biological half- life (5- 8 hours) than cocaine (0.5- 1.5 hours), and can generally be detected for 24- 48 hours after cocaine exposure 2 . The COC One Step Cocaine Test Strip 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 cocaine metabolite in urine. The COC One Step Cocaine Test Strip yields a positive result when the cocaine metabolite in urine exceeds 300 ng/ mL. This is the suggested screening cut- off for positive specimens set by the Substance Abuse and Mental Health Services Administration (SAMHSA, USA).      >>back to top

Methadone: Methadone is a narcotic pain reliever for medium to severe pain. It is also used in the treatment of heroin (opiate dependence: Vicodin, Percocet, Morphine, etc.) addiction. Oral Methadone is very different than IV Methadone. Oral Methadone is partially stored in the liver for later use. IV Methadone acts more like heroin. In most states you must go to a pain clinic or a Methadone maintenance clinic to be prescribed Methadone. Methadone is a long acting pain reliever producing effects that last from twelve to forty- eight hours. Ideally, Methadone frees the client from the pressures of obtaining illegal heroin, from the dangers of injection, and from the emotional roller coaster that most opiates produce. Methadone, if taken for long periods and at large doses, can lead to a very long withdrawal period. The withdrawals from Methadone are more prolonged and troublesome than those provoked by heroin cessation, yet the substitution and phased removal of methadone is an acceptable method of detoxification for patients and therapists. 1 The MTD One Step Methadone Test Strip 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 Methadone in urine. The MTD One Step Methadone Test Strip yields a positive result when the Methadone in urine exceeds 300 ng/ mL.      >>back to top

Methamphetamine: Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects of Methamphetamine are greater. Methamphetamine is made in illegal laboratories and has a high potential for abuse and dependence. The drug can be taken orally, injected, or inhaled. 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 Methamphetamine include increased blood pressure and cardiac arrhythmias. More acute responses produce anxiety, paranoia, hallucinations, psychotic behavior, and eventually, depression and exhaustion. The effects of Methamphetamine generally last 2- 4 hours and the drug has a half- life of 9- 24 hours in the body. Methamphetamine is excreted in the urine primarily as amphetamine and oxidized and deaminated derivatives. However, 10- 20% of Methamphetamine is excreted unchanged. Thus, the presence of the parent compound in the urine indicates Methamphetamine use. Methamphetamine is generally detectable in the urine for 3- 5 days, depending on urine pH level. The mAMP One Step Methamphetamine Test Strip 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 Methamphetamine in urine. The mAMP One Step Methamphetamine Test Strip yields a positive result when the Methamphetamine in urine exceeds 1,000 ng/ mL.      >>back to top

Morphine: Opiates, including heroin, morphine, and codeine, are derived from the opium poppy. Medicinally, opiates are used for pain management and cough reduction. Heroin is an illicit analog of morphine that breaks down in the body to 6- acetylmorphine, morphine and morphine glucuronide. The biological half-lives for opiates range from 3-4 hours. In the urine, opiates are detectable up to 3 days after use. Morphine is the metabolite of both heroin and codeine; morphine (or morphine glucuronide) in the urine could indicate morphine, heroin and/or codeine use. Phencyclidine: Phencyclidine is an arylcyclohexylamine that was originally developed for use as an anesthetic. Although used in veterinary medicine as a tranquilizer, the use of the drug in humans was discontinued due to the negative side effects. PCP is manufactured illegally and sold on the streets under the names "angel dust", "ozone" and "crystal cyclone,". Common physical effects of the drug include hallucinations, disorientation, muscular incoordination and delusions. The half-life of PCP is about 12 hours. The detection window in urine is up to 5 days for infrequent use and up to 20 days for chronic use.      >>back to top

OPIATE (MOP 300 or OPI 300)
Opiate refers to any drug that is derived from the opium poppy, including the natural products, morphine and codeine, and the semi- synthetic drugs such as heroin. Opioid is more general, referring to any drug that acts on the opioid receptor. Opioid analgesics comprise a large group of substances which control pain by depressing the central nervous system. Large doses of morphine can produce higher tolerance levels, physiological dependency in users, and may lead to substance abuse. Morphine is excreted unmetabolized, and is also the major metabolic product of codeine and heroin. Morphine is detectable in the urine for several days after an opiate dose. The FirstStep Opiate Test Strip 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 opiates in urine. The FirstStep Opiate Test Strip yields a positive result when the concentration of opiate exceeds the 300 ng/ mL cut- off level.

OPIATE (2000)
The test utilizes a monoclonal antibody to selectively detect elevated levels of morphine in urine. The OPI One Step Opiate Test Strip yields a positive result when the morphine in urine exceeds 2,000 ng/ mL. This is the suggested screening cut- off for positive specimens set by the Substance Abuse and Mental Health Services Administration (SAMHSA, USA).      >>back to top

PHENCYCLIDINE (PCP): Phencyclidine, also known as PCP or Angel Dust, is a hallucinogen that was first marketed as a surgical anesthetic in the 1950's. It was removed from the market because patients receiving it became delirious and experienced hallucinations. Phencyclidine is used in powder, capsule, and tablet form. The powder is either snorted or smoked after mixing it with marijuana or vegetable matter. Phencyclidine is most commonly administered by inhalation but can be used intravenously, intra- nasally, and orally. After low doses, the user thinks and acts swiftly and experiences mood swings from euphoria to depression. Self- injurious behavior is one of the devastating effects of Phencyclidine. PCP can be found in urine within 4 to 6 hours after use and will remain in urine for 7 to 14 days, depending on factors such as metabolic rate, user's age, weight, activity, and diet. 5 Phencyclidine is excreted in the urine as an unchanged drug (4% to 19%) and conjugated metabolites (25% to 30%). 6 The PCP One Step Phencyclidine Test Strip 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 phencyclidine metabolite in urine. The PCP One Step Phencyclidine Test Strip yields a positive result when the phencyclidine metabolite in urine exceeds 25 ng/ mL. This is the suggested screening cut- off for positive specimens set by the Substance Abuse and Mental Health Services Administration (SAMHSA, USA).      >>back to top

Marijuana/THC: THC ( . 9-- tetrahydrocannabinol) is the primary active ingredient in cannabinoids (marijuana). When smoked or orally administered, it produces euphoric effects. Users have impaired short term memory and slowed learning. They may also experience transient episodes of confusion and anxiety. Long term relatively heavy use may be associated with behavioral disorders. The peak effect of smoking marijuana occurs in 20- 30 minutes and the duration is 90- 120 minutes after one cigarette. Elevated levels of urinary metabolites are found within hours of exposure and remain detectable for 3- 10 days after smoking. The main metabolite excreted in the urine is 11- nor- . 9- tetrahydrocannabinol- 9- carboxylic acid ( . 9- THC- COOH). The THC One Step Marijuana Test Strip 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 marijuana in urine. The THC One Step Marijuana Test Strip yields a positive result when the concentration of marijuana in urine exceeds 50 ng/ mL. This is the suggested screening cut- off for positive specimens set by the Substance Abuse and Mental Health Services Administration (SAMHSA, USA).      >>back to top

Tricyclic Antidepressants: Tricyclic Antidepressants (TCA), used in the treatment of depressive disorders, are often implicated in accidental and intentional overdoses. Members of this drug class include amitriptyline, nortriptyline, imipramine, desipramine and clomipramine. TCA overdoses can result in profound central nervous system depression, cardiotoxicity and anticholinergic effects. Half-lives for these drugs range from 2 to 70 hours. Detection times in urine vary depending on duration of drug use.

<< back to top

TEST PRINCIPLE

The FirstStep Drug Screen Test Card is an immunoassay based on the principle of competitive binding. Drugs which may be present in the urine specimen compete against their respective drug conjugate for binding sites on their specific antibody. During testing, a urine specimen migrates upward by capillary action. A drug, if present in the urine specimen below its cut- off concentration, will not saturate the binding sites of its specific antibody. The antibody will then react with the drug- protein conjugate and a visible colored line will show up in the test line region of the specific drug strip. The presence of drug above the cut- off concentration will saturate all the binding sites of the antibody. Therefore, the colored line will not form in the test line region. A drug- positive urine specimen will not generate a colored line in the specific test line region of the strip because of drug competition, while a drug- negative urine specimen will generate a line in the test line region because of the absence of drug competition. 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.

<< back to top

STORAGE AND STABILITY

Store as packaged in the sealed pouch at 2- 30° C. The test strip is stable through the expiration date printed on the sealed pouch. The test strips must remain in the sealed pouch until use. DO NOT FREEZE. Do not use beyond the expiration date.

<< back to top

PRECAUTIONS

• 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 panel 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 card should be discarded according to federal, state and local regulations.

<< back to top

REAGENTS AND MATERIALS SUPPLIED

The test contains a membrane strip coated with drug- protein conjugates (purified bovine albumin) on the test line, a goat polyclonal antibody against gold- protein conjugate at the control line, and a dye pad which contains colloidal gold particles coated with mouse monoclonal antibody specific to Amphetamine, Cocaine, Methamphetamine, Morphine, THC, Phencyclidine, Benzodiazepine, Methadone or Barbiturate.

• Test Card
• Package Insert

MATERIALS REQUIRED BUT NOT PROVIDED

• Specimen collection container.
• Timer.
• External Controls

<< back to top

SPECIMEN COLLECTION AND HANDLING

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 precipitates should be centrifuged, filtered, or allowed to settle to obtain a clear specimen for testing.
Specimen Storage
Urine specimens may be stored at 2- 8° C for up to 48 hours prior to testing. For prolonged storage, specimens may be frozen and stored below -20° C. Frozen specimens should be thawed and mixed well before testing.

<< back to top

TEST PROCEDURE

Allow the test panel, urine specimen, and/ or controls to equilibrate to room temperature (15- 30 ° C) prior to testing.
1.Bring the pouch to room temperature before opening it. Remove the test panel from the sealed pouch and use it as soon as possible.
2.Remove the cap from the end of the test card. With arrows pointing toward the urine specimen, immerse the strip( s) of the test card vertically in the urine specimen for at least 10- 15 seconds. Do not pass the arrow( s) on the test panel when immersing the panel. See the illustration below.
3.Place the test card on a non- absorbent flat surface, start the timer and wait for the red line( s) to appear. The results should be read at 5 minutes. Do not interpret results after 10 minutes.

<< back to top

INTERPRETATION OF RESULTS

NEGATIVE:*
Two lines appear
.One red line should be in the control region (C), and another apparent red or pink line adjacent should be in the test region (T). This negative result indicates that the drug concentration is below the detectable level.
*NOTE:
The shade of red in the test line region (T) will vary, but it should be considered negative whenever there is even a faint pink line.

POSITIVE:
One red line appears in the control region (C). No line appears in the test region (T). This positive result indicates that the drug concentration is above the detectable level.

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 panel. If the problem persists, discontinue using the lot immediately and contact your local distributor.

<< back to top

QUALITY CONTROL

A procedural control is included in the test. A red 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.

<< back to top

LIMITATIONS

1.The One Step Drug Screen Test Card provides only a qualitative, preliminary analytical result.
A secondary analytical method must be used to obtain a confirmed result. Gas chromatography and mass spectrometry (GC/ MS) is the preferred confirmatory method. 3,4,7
2. There is a possibility 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 cut- off level of the test.
6. Test does not distinguish between drugs of abuse and certain medications.

<< back to top

EXPECTED RESULTS

<< back to top

PERFORMANCE CHARACTERISTICS

Accuracy
A side- by- side comparison was conducted using the One Step Single Drug Test Strip and commercially available drug rapid tests. Testing was performed on approximately 1,700 specimens previously collected from subjects presenting for Drug Screen Testing. Presumptive positive results were confirmed by GC/ MS. The following compounds were quantified by GC/ MS and contributed to the total amount of drugs found in presumptive positive urine samples tested.

Forty (40) clinical samples for each drug were run using each of The One Step Single Drug Test Strip by an untrained operator at a Professional Point of Care site. Based on GC/ MS data, the operator obtained statistically similar Positive Agreement, Negative Agreement and Overall Agreement rates as trained laboratory personnel.

Precision and Analytical Sensitivity
A study was conducted at three physician offices by untrained operators using three different lots of product to demonstrate the within run, between run and between operator precision. An identical panel of coded specimens, containing drugs at the concentration of ± 50% and ± 25% cut- off level, was labeled, blinded and tested at each site. The results are given below:

Analytical Specificity
The following table lists the concentration of compounds (ng/ mL) that are detected positive in urine by One Step Drug Screen Test Card at 5 minutes.

AMPHETAMINE
ng/mL
D-Amphetamine 1,000
D,L-Amphetamine sulfate 3,000
L-Amphetamine 50,000
(±)3,4-Methylenedioxyamphetamine 2,000
Phentermine 3,000
BARBITURATES
Secobarbital 300
Amobarbital 300
Alphenol 150
Aprobarbital 200
Butabarbital 75
Butalbital 2,500
Butethal 100
Cyclopentobarbital 600
Pentobarbital 300
Phenobarbital 100
BENZODIAZEPINES
Oxazepam 300
Alprazolam 196
a-Hydroxyalprazolam 1,262
Bromazepam 1,562
Chlordiazepoxide 1,562
Chlordiazepoxide HCI 781
Clobazam 98
Clonazepam 781
Clorazepate dipotassium 195
Delorazepam 1,562
Desalkylflurazepam 390
Diazepam 195
Estazolam 2,500
Flunitrazepam 390
(±)Lorazepam 1,562
RS-Lorazepam glucuronide 156
Midazolam 12,500
Nitrazepam 98
Norchlordiazepoxide 195
Nordiazepam 390
Oxazepam 300
Temazepam 98
Triazolam 2,500
COCAINE
Benzoylecgonine 300
Cocaine HCl 780
Cocaethylene 12,500
Ecgonine HCl 32,000
MARIJUANA (THC)
11-nor-.9-THC-9 COOH 50
Cannabinol 20,000
11-nor-.8-THC-9 COOH 30
.8-THC 15,000
.9-THC 15,000
METHADONE
Methadone 300
Doxylamine 50,000
METHAMPHETAMINE
D-Methamphetamine 1,000
ñ-Hydroxymethamphetamine 30,000
L-Methamphetamine 8,000
(±)-3,4-Methylenedioxymethamphetamine2,000
Mephentermine 50,000
OPIATE 300 (MOP)
Morphine 300
Codeine 300
Ethylmorphine 6,250
Hydrocodone 50,000
Hydromorphone 3,125
Levophanol 1500
6-Monoacetylmorphine 400
Morphine 3-â-D-glucuronide1,000
Norcodeine 6,250
Normorphone 100,000
Oxycodone 30,000
Oxymorphone 100,000
Procaine 15,000
phebaine 6,250
OPIATES (2000)
Morphine 2,000
Codeine 2,000
Ethylmorphine 5,000
Hydrocodone 12,500
Hydromorphone 5,000
Levophanol 75,000
6-Monoacetylmorphine 5,000
Morphine 3-â-D-glucuronide 2,000
Norcodeine 12,500
Normorphone 50,000
Oxycodone 25,000
Oxymorphone 25,000
Procaine 150,000
Thebaine 100,000
PCP Phencyclidine 25
4-Hydroxyphencyclidine 12,500

Effect of Urinary Specific Gravity
Fifteen (15) urine samples of normal, high, and low specific gravity ranges (1.000- 1.037) were spiked with drugs at 50% below and 50% above cut- off levels respectively. The One Step Drug Screen Test Card was tested in duplicate using fifteen drug- free urine 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 drugs at 50% below and 50% above cut- off levels. The spiked, pH- adjusted urine was tested with One Step Drug Screen Test Card. 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 drug positive urine containing Cocaine, Barbiturates, Benzodiazepine, Amphetamine, Methamphetamine, Marijuana, Methadone, Opiate or Phencyclidine. The following compounds show no cross- reactivity when tested with One Step Drug Screen Test Card at a concentration of 100 µ g/ mL.

Non Cross-Reacting Compounds
Acetaminophen Maprotiline
Acetophenetidin MDE
N-Acetylprocainamide Meperidine
Acetylsalicylic acid Meprobamate
Aminopyrine Amitryptyline Methoxyphenamine
Amoxicillin Nalidixic acid
Ampicillin Naloxone
L-Ascorbic acid Naltrexone Naproxen
Apomorphine Niacinamide
Aspartame
Nifedipine
Atropine Norethindrone
Benzilic acid D-
Norpropoxyphene
Benzoic acid Noscapine
Benzphetamine DL-
Octopamine
Bilirubin Oxalic acid
(±)-Brompheniramine Caffeine Oxolinic acid
Cannabidiol Oxymetazoline
Chloralhydrate Papaverine
Chloramphenicol Penicillin-G
Chlorothiazide Pentazocine hydrochloride
(±)-Chlorpheniramine Perphenazine
Chlorpromazine Phenelzine
Chlorquine Trans-2-phenylcyclo-propylamine
Cholesterol hydrochloride
Clomipramine L-Phenylephrine
Clonidine
â-Phenylethylamine
Cortisone Phenylpropanolamine
(-)Cotinine Prednisolone
Creatinine Prednisone
Deoxycorticosterone Promazine
Dextromethorphan Promethazine DL-
Propranolol
Diclofenac D-
Propoxyphene
Diflunisal D-
Pseudoephedrine
Digoxin Quinacrine
Diphenhydramine Quinidine
Doxylamine Quinine
(-)-Ø -Ephedrine Ranitidine
â-Estradiol Salicylic acid
Estrone-3-sulfate Serotonin
Ethyl-p-aminobenzoate Sulfamethazine
[1R,2S](-)Ephedrine Sulindac
(L)-Epinephrine Erythromycin Tetracycline
Fenoprofen Tetrahydrocortisone, 3-acetate
Furosemide Tetrahydrocortisone 3-Gentisic acid (â-D-glucuronide)
Hemoglobin Tetrahydrozoline
Hydralazine Thiamine
Hydrochlorothiazide Thioridazine
Hydrocortisone DL-Tyrosine
O-Hydroxyhippuric acid Tolbutamide
p-Hydroxyamphetamine Triamterene
3-Hydroxytyramine Trifluoperazine
Ibuprofen Trimethoprim
Imipramine Trimipramine
Iproniazid Tryptamine
(±)-Isoproterenol DL-Tryptophan
Isoxsuprine Tyramine
Ketamine Uric acid
Ketoprofen Verapamil
Labetalol Zomepirac
Loperamide

<< back to top