COLLECTION OF THERAPEUTIC DRUGS

Size: px

Start display at page:

Download "COLLECTION OF THERAPEUTIC DRUGS"

Horatio Cook
5 years ago
Views:

COLLECTION OF THERAPEUTIC DRUGS The following may be used as a guide for the collection times of therapeutic drugs, when not indicated specifically by physician orders.

1 COLLECTION OF THERAPEUTIC DRUGS The following may be used as a guide for the collection times of therapeutic drugs, when not indicated specifically by physician orders. DRUG RECOMMENDED SPECIMEN COLLECTION TIME Amikacin Depakene (Valproic acid) Digitoxin (Digitalis) Digoxin (Lanoxin) Dilantin (Phenytoin) Ethosuximide Flecainide Gentamicin Lamictal (Lamotrigine) Lithium Mysoline (Primidone) Neurontin Nortriptyline Phenobarbital Quinidine Tacrolimus (Prograf) Peak level (IV) 30 minutes post (30 minute infusion); immediately after 60 minute infusion) Peak level (IM) 60 minutes post infusion 1 3 hours after administration hours after last dose 18 hours after administration 2 4 hours after administration 2 4 hours after oral capsule; 1 2 for syrup 1 hour prior to next dose Peak level (IV) 30 minutes post (30 minute infusion); immediately after 60 minute infusion) Peak level (IM) 60 minutes post infusion Prior to next dose Prior to next dose 2 4 hours after administration 2 hours post last dose Prior to next dose or 12 hours post last dose 6 hours after administration Quinidine sulfate 1 hour after oral dose Quinidine gluconate 5 hours after oral dose 1 hour prior to next dose

2 Sirolimus (Rapamycin) Tegretol Theophylline Vancomycin ½ to 1 hour prior to next dose 2 hours after administration 30 min post completion of IV loading dose; 4 8 hrs post start of IV infusion; 2 hours post oral dose, solutions or rapid solids; 4 hours post oral dose, slow release formulations; 3 7 hours post dose of Theodur Peak level 30 minutes post administration

3 PATIENT PREPARATION The following tests have recommended patient preparation. Order Choice (Test) Patient Preparation Androstenedione Early morning specimen is preferred. Arsenic, Blood Cadmium, Blood Catecholamines 24 Hr Urine Catecholamines, plasma Chlamydia/GC Urine by PCR Cortisol, salivary Fecal Fat Glucose 2 Hour Post Prandial Heavy Metals, Random Urine Refrain from eating seafood or herbal supplements 3 days prior to blood Refrain from shellfish, shrimp, crab, lobster, and flounder for at least 3 days prior to The patient is preferred to be off any medication for 3 days prior to Common antihypertensives (diuretics, ace inhibitors,calcium channel blockers, alpha and beta blockers) may cause minimal or no interference, Patient should avoid tobacco, tea, coffee and strenuous exercise prior to strenuous exercise prior to Overnight fast is required. Patient should not urinate within 1 hour prior to Refrain from eating food or smoking cigarettes for 1 hour prior to sample Patient diet should include 100 grams of fat per day for 3 days prior Adequate meal of glucose 2 hours before testing. Meal should be completed within minutes. Patient should not eat or smoke during 2 hour window. Refrain from eating shellfish and herbal or mineral supplements prior to

4 Heavy metals, Blood ifob Lipid Profile Mercury, Blood Metanephrines Fractionated, 24 Hour Urine Metanephrines, Plasma Myoglobin, Urine Occult Blood (Guiac test) Refrain from eating shellfish and herbal or mineral supplements prior to No special dietary restrictions required. A hour fast is recommended. Patient should not smoke prior to Alcohol may interfere with test results and should not be ingested hours prior to Refrain from eating swordfish, tuna and shark 3 days prior to strenuous exercise prior to strenuous exercise prior to Overnight fasting is preferred. First voided sample is desired. Keep refrigerated. Room temperature is unacceptable. Follow dietary instructions: Diet 2 days prior to testing: Meat small amounts of wellcooked chicken, tuna or turkey. Vegetables Generous amounts of cooked vegetables. Raw vegetables are also permitted except for turnips, cauliflower, red radishes, broccoli, cantaloupe, horseradish and parsnips. Fruits Plenty of fruits especially prunes and apples. Cereals Bran and bran containing cereals, Moderate amount of peanuts and popcorn daily. Other restrictions: The following medication restrictions should be followed after consultation with physician: No aspirin or anti inflammatory medicines for 7 days prior to collection; Do not use supplements which contain Vitamin C(ascorbic acid) in excess of 250 mg/day; Do not use rectal medicines or tonics.

5 Oxalate, 24 Hour Urine Refrain from taking excessive amonunts of Vitamin C or oxalate rich foods such as coffee, spinach, tea, chocolate or rhubarb for 48 hours prior to Serotonin Refrain from eating indole rich foods such as avocado, banana, tomato, plum, walnut, pineapple, and eggplant. Avoid coffee tea and tobacco 3 days prior to VAP Cholesterol Requires hour fast. No alcohol for 24 hours. Vitamins A, B6, C or E Overnight fasting is preferred. Avoid vitamin supplements 24 hours prior to VMA, 24 Hour Urine The patient is preferred to be off any medication for 3 days prior to Common antihypertensives (diuretics, ace inhibitors,calcium channel blockers, alpha and beta blockers) may cause minimal or no interference, Patient should avoid tobacco, tea, coffee and strenuous exercise prior to

24 Hour Urine Testing

24 Hour Urine Testing 24 Hour Urine ing The preferred collection container is identified in bold. Acceptable preservatives are listed that may be used when more than one test is ordered and the preferred preservatives are different