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Test Code LAB31 Phenytoin, Total, Plasma or Serum

Reporting Title

Phenytoin

Methodology

Roche Diagnostics: RMH, BH, DH, GMC, GMH, MGH, MH, OBH, SH Core Laboratories

Used to monitor dose and overdose of phenytoin, an anticonvulsant.

Performing Laboratory

OhioHealth Laboratory Services - RMH, BH, DH, GMC, GMH, MGH, MH, OBH, SH Core Laboratories

Specimen Requirements

Collection Instructions:

1. Serum and Plasma gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.

 

Submit only 1 of the following specimens:

 

Preferred:

Serum

Draw blood in a gold-top serum gel tube(s). Spin down and send 1 mL of serum refrigerated. Specimen is usually drawn 2 hours post infusion or 15 minutes before dose for intravenous piggyback (IVPB) or intravenous push (IVP). For an oral dose, specimen is drawn immediately prior to next dose.

Note:

1. Patients receiving fosphenytoin should wait at least 2 hours after an intravenous administration and 4 hours after an intramuscular administration before having blood drawn.

2. Date and time of draw is required on request form and specimen for processing.

3. A speckled-top serum gel tube (s) or a plain, red-top tube(s) is also acceptable.

4. Indicate serum and if draw is pre- or post-dose on request form.
5. Label specimen appropriately (serum and as pre- or post-dose).

 

Alternate: 

Plasma

Draw blood in a mint green-top (heparin) gel tube(s). Spin down and send 1 mL of heparinized plasma refrigerated. Specimen is usually drawn 2 hours post infusion or 15 minutes before dose for intravenous piggyback (IVPB) or intravenous push (IVP). For an oral dose, specimen is drawn immediately prior to next dose.

Note:  1. Patients receiving fosphenytoin should wait at least 2 hours after an intravenous administration and 4 hours after an intramuscular administration before having blood drawn.

2. Date and time of draw is required on request form and specimen for processing.

3. Indicate plasma and if draw is pre- or post-dose on request form.
4. Label specimen appropriately (plasma and as pre- or post-dose).

Specimen Stability Information

Specimen Type Temperature Time
Serum or plasma Refrigerated 4 days capped
  Ambient  4 days capped
  Frozen  2 months capped

 

Specimen Transport Temperature

Refrigerate/Frozen OK/Ambient OK

Reference Values

Therapeutic concentration

Neonates:  6-15 mcg/mL

Children and adults:  10-20 mcg/mL

Critical values Neonates:  >15 mcg/mL  Children and adults:  >25 mcg/mL

Alerting category: Always called within 1 hour

Note:  Phenobarbital may increase or decrease phenytoin levels. A free phenytoin level can identify protein-binding problems in uremic patients.

Day(s) Test Set Up

Monday through Sunday; Continuously

Test Classification and CPT Coding

80185