gmL 0.1 gmL gmL 500 ngml

27 SI Units International System of Units Drug Therapeutic Range Toxic Level amikacin amitriptyline carbamazepine clonazepam desipramine diazepam digoxin disopyramide ethosuximide flecainide gentamicin imipramine lignocaine lithium nortriptyline phenobarbitone phenytoin primidone procainamide quinidine salicylic acid theophylline tobramycin valproic acid vancomycin LABS A-F peak: 34–51 ␮molL trough: 7–14 ␮molL 433–903 nmolL 21–51 ␮molL 40–200 nmolL 281–1125 nmolL 0.35–3.5 nmolL 1–2.6 nmolL 9–18 ␮molL 280–708 ␮molL 0.5–2.4 ␮molL peak:12–21 ␮molL trough:4 molL 610–1670 nmolL 6–21 molL 0.5–1.5 mmolL 190–570 nmolL 86–172 molL 40–80 molL 23–55 molL 17–42 molL 6–15 molL 1–2 mmolL 28–111 molL peak: 13–21 molL trough: 4 molL 350–700 molL peak: 14–28 molL trough: 3–7 molL peak: 60 molL 805 nmolL 51 molL 260 nmolL 1500 nmolL 17.5 nmolL

2.6 nmolL 21 molL

1062 molL 2.4 molL peak: 21 molL 1785 nmolL 39 molL 2 mmolL 1900 nmolL 172 molL 158 molL 55 molL 51 molL 29 molL

3.6 mmolL 111 molL

peak: 21 molL 1386 molL peak: 28 molL Copyright © 2005 F. A. Davis. 28 A-F . Red-top tube. ■ Drug levels are obtained both to enhance therapeutic efficacy and to assess for toxicityoverdosepoisoning. ■ Therapeutic drug monitoring TDM is the measurement of serum drug levels so that dosages may be adjusted to achieve optimum clinical benefit. ■ Therapeutic drug monitoring is used with ◆ cardiac glycosides e.g., digoxin ◆ antiarrhythmics e.g., lidocaine, procainamide ◆ anticonvulsants e.g., phenytoin, carbamazepine ◆ lithium ◆ theophylline ◆ aminoglycoside antibiotics gentamicin, tobramycin ◆ salicylates ■ For TDM, blood samples must be obtained at the appropriate time and after sufficient number of doses have been administered for valid interpretation of results. ■ Peak and trough levels are drawn with some drugs, especially antibiotics. Peak levels are drawn at the point of maximum drug absorption; trough levels are drawn just before the next dose. Electrolytes, Serum See individual tests for normal values. . Red-top tube. ■ Electrolytes are minerals present in body tissues and blood as dissolved salts. ■ They are electrically charged particles that help maintain fluid and acid-base balance. They help move nutrients into cells and waste products out. ■ An electrolyte panel measures sodium Na ⫹ , potassium K ⫹ , chloride Cl - , and bicarbonate HCO3 - , which is measured indirectly as CO 2 . ■ See individual tests and Anion Gap for more information. Copyright © 2005 F. A. Davis.