Department

Toxicology

Preferred Sample Type

Urinary Antihypertensive Drug Screen

Suitable Specimen Types

  • Plain Spot Urine
500 µL minimum.

Specimen Transport

First class post

Sample Processing in Laboratory

Place in UAHS box in send away freezer

Sample Preparation

Centrifuge

Turnaround Time

1 week

Sample Stability

Store at -20 °C

Urinary Antihypertensive Drug Screen

General Information

Arterial hypertension is one of the most preventable causes of premature morbidity and mortality with resistant hypertension reported to be present in 5 to 30% of the total hypertensive population. The resistant hypertensives have much worse prognosis. Poor adherence with prescribed medication is a common cause of resistance to treatment, with as many as 53% reported to be non-adherent.

This Urinary Antihypertensive Drug Screen by LC-QTof MS  is an objective test of adherence which is easy to administer, quick, inexpensive and reliable and may be used to identify patients with true resistance to antihypertensive treatment.

As of 1st of May 2019, the following drugs are screened for:

ACE inhibitors

Ramipril, Enalapril, Lisinopril, Quinapril, Perindopril, Fosinopril

Calcium Channel blockers

Amlodipine, Felodipine, Lercanidipine, Lacidipine, Nifedipine, Diltiazem, Verapamil

Beta Blockers

Atenolol, Bisoprolol, Labetolol, Metoprolol, Propranolol, Carvedilol, Nebivolol

Angiotensin II Receptor Antagonists

Candersartan, Olmesartan, Losartan, Telmisartan, Valsartan, Irbesartan

 

Diuretics

Chlorothiazide, Hydrochlorothiazide, Bendroflumethiazide, Indapamide, Bumetanide, Metolazone, Chlorthalidone, Amiloride, Furosemide, Spironolactone

Anti-diabetic Drugs

Chlorpropamide, Glibenclamide, Glimepiride, Gliclazide, Glipizide, Tolbutamide and Metformin

 

Renin Inhibitors

Aliskiren

 

Statins

Atorvastatin, Rosuvastatin

 

Others

Clonidine, Doxazosin, Minoxidil, Moxonidine

Other drugs such as those used for treatment of heart failure (e.g. ivabradine), anticoagulant drugs (e.g. warfarin, rivaroxaban), antiplatelet drugs (e.g. clopidogrel) and gliptins (e.g. sitagliptin) are screened for but are not reported. If a requesting physician requires adherence to these drugs to be investigated please contact the laboratory on 0121 424 3707. 

Patient Preparation

For patients:

First pass urine of the day should be collected into a plain (white top) universal container. Prescribed medication should be taken as usual.

For requesting clinical staff:

Please state name and dose of drugs prescribed, together with the time patient has been instructed to take medication, on the request form. Transport to the laboratory as soon as possible.

Reference Range

This is a screening tests. Drugs detected in specimens will be stated on the report.

Specifications

  • EQA Scheme?: No
  • EQA Status: No EQA scheme available. Take part in sample exchange scheme.

The laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital form part of the services provided by University Hospitals Birmingham and are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/

  • Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217
  • United Kingdom Health Security Agency laboratory is a UKAS accredited medical laboratory No.8213

Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further test information, please visit the test database: http://www.heftpathology.com/frontpage/test-database.html.

Protection of personal information - Laboratory Medicine comply with the Trust Data Protection policy and have procedures in place to allow the Directorate and its employees to comply with the Data Protection act  1998 and associated best practice and guidance.

For further information contact Louise Fallon, Quality Manager, 0121 424 1235

UKAS HEFT