Test not available outside normal working hours.
Tubes containing gel (SST and PST) are NOT acceptable
Please contact the laboratory if you require testing on a specific sample e.g. admission bloods.
These drugs can also be screened for in urine. Please make a note on the request form.
Refer to the urine drug screening page in the test guide for more information.
Performed Weekly.
Liquid Chromatography - Time of Flight Mass Spectrometry (LC-QTOF-MS)
The presence of sulphonylurea drugs should be excluded in the patient who presents with a suspected insulinoma. Hypoglycaemia may occur in both diabetic and non-diabetic patients and may be caused by the surreptitious use of sulphonylurea drugs, exogenous insulin, or inappropriate endogenous insulin secretion (insulinoma). Exclusion of drug exposure is an important diagnostic step.
The LC-QTOF method now used can qualitatively detect the presence of absence of a range of sulphonylurea drugs, as well as a number of other non-sulphonylurea drugs potentially relevant to a patient presenting with hypoglycaemia (some of these drugs when used alone may not cause hypoglycaemia, and some are not available in New Zealand but may be brought into the country if prescribed overseas). The list includes:
The method used does not detect insulin or GLP1 receptor agonists (e.g. dulaglutide, liraglutide). If exogenous insulin use is suspected please contact the laboratory.
The QTOF analysis can sometimes detect other drugs, but is not a general drug screen, which requires urine. Refer to urine drug screen.
The clearance of the Sulphonylurea drugs is fast. They will only be detectable for 1-2 days after dosage. The method does not screen for the presence of metabolites.
If the clinical query if possible metformin toxicity (e.g. as a possible cause of lactic acidosis) please contact the laboratory. In the appropriate clinical context this can be performed by a quantitative HPLC method at Counties Manukau.
This test is not to be used for Therapeutic drug monitoring and guidance of doses
Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.
If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).
Individual chemical pathologists may be contacted but will not be available at all times.
After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.
Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402
Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052
Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427
Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427
Dr Sakunthala Jayasinghe: Sakunthala@adhb.govt.nz ext. 23427
Aliquot : 0.5 mL serum.
Centrifuge and separate blood as soon as possible after collection.
If sending within Auckland then sample can be sent refrigerated (2-8 degrees) or at ambient temperature (8-24 degrees).
If sending from outside Auckland then send sample refrigerated (2-8 degrees).
Note: If temperature during shipping is likely to exceed 24 degrees then results may not always be reliable.