Test Code LAB32 Phenytoin, Free, Plasma or Serum
Additional Codes
46295
Reporting Title
Free Phenytoin
Methodology
Roche Diagnostics
Free phenytoin (not bound to protein) is the pharmacologically active form of drug. Any alteration of protein binding due to uremia, hypoalbuminemia, ingestion of other drugs, or age can affect clinical response.
Performing Laboratory
OhioHealth Laboratory Services-RMH Core Laboratory
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. Pre-dose specimen is recommended.
Note: 1. Patients receiving fosphenytoin should be drawn at least 2 hours after an intravenous dose and 4 hours after an intramuscular administration to prevent cross reactivity.
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 on request form.
5. Label specimen appropriately (serum).
Alternate:
Plasma
Draw blood in a mint green-top (heparin) gel tube(s). Spin down and send 1 mL of heparinized plasma refrigerated. Pre-dose specimen is recommended.
Note: 1. Patients receiving fosphenytoin should be drawn at least 2 hours after an intravenous dose and 4 hours after an intramuscular administration to prevent crossreactivity.
2. Date and time of draw is required on request form and specimen for processing.
3. Indicate plasma on request form.
4. Label specimen appropriately (plasma).
Sample Stability Information:
Stable 7 days refrigerated
Specimen Transport Temperature
Refrigerate/Ambient OK/Frozen OK
Reference Values
Therapeutic concentration: 1.0-2.0 mcg/mL
Critical value >2.0 mcg/mL
Alerting category: Always called within 1 hour
Note: Uremic specimens may show a positive bias.
Day(s) Test Set Up
Monday through Sunday; Continuously
Test Classification and CPT Coding
80186