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Amikacin Peak (AMIKP)

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EPIC Test Name

AMIKACIN PEAK

EPIC Code

LAB2548

Specimen Requirements

plasma
Minimum Volume:0.5 mL
Collection:Collect using standard laboratory procedures
Transport:Room Temperature ASAP
Stability:Room Temperature: 8 hours capped at 15-25 degrees C
Refrigerated: 48 hours capped at 2-8 degrees C
Frozen: 4 weeks capped at -20 degrees C
Avoid repeat freezing and thawing
Container:LIT-GRN
Rejection Causes:Insufficent Sample Volume
Notes:Peak specimens should be obtained 30-90 minutes after administration

Methods

Homogeneous Enzyme Immunoassay Technique

Turnaround Time

SpecimenTurnaround TimeFrequency
plasmaStat: 90 minutes Routine: 4 hours24/7

Reference Ranges

Homogeneous Enzyme Immunoassay Technique
UnitCritical ValuesTherapeutic Levels
ug/mL>30.0 ug/mL20.0-25.0 ug/mL

Clinical Indications

Amikacin is an aminoglycoside, a bactericidal drug against a wide range of pathogens, by inducing bacterial death by irreversibly binding bacterial ribosomes to inhibit protein synthesis. Amikacin is used to treat severe blood infections by susceptible strains of gram-negative bacteria. Amikacin is minimally absorbed from the gastrointestinal tract, and thus can been used orally to reduce intestinal flora.
Determination of serum or plasma drug levels is required to achieve optimum therapeutic efficacy and minimize toxicity.
In the circulation, the peak concentration is seen 30 minutes after intravenous infusion, or 60 minutes after intramuscular administration. Amikacin’s half-lives in patients with normal renal function are generally 2 to 3 hours. Excretion of amikacin is principally renal and may accumulate in the kidney, therefore, its concentration in urine can much higher (50 to 100 times) than the serum concentration.
Toxicity can cause patients to feel dizziness, vertigo, or, if severe, ataxia and a Meniere disease-like syndrome. Auditory toxicity may be manifested by simple tinnitus or any degree of hearing loss, which may be temporary or permanent, and can extend to total irreversible deafness. Nephrotoxicity is most frequently manifested by transient proteinuria or azotemia, which may occasionally be severe. Aminoglycosides also are associated with variable degrees of neuromuscular blockade leading to apnea.

Performed

Lab
Chemistry - Downtown

Interpretative Information

For conventional (nonpulse) dosing protocols, clinical effects may not be achieved if the peak serum concentration is <20.0 mcg/mL. Toxicity may occur if the peak serum concentration is maintained >30.0 mcg/mL for a prolonged period of time.

CPT

80150

LOINC

3319-1

References

1. Hammett-Stabler CA, Johns T. Laboratory Guidelines for Monitoring of Antimicrobial Drugs. National Academy of Clinical Biochemistry. Clin Chem 1998;44:1129-40. https://doi.org/10.1093/clinchem/44.5.1129
2. Gonzalez LS III, Spencer JP: Aminoglcosides: A practical review. Am Fam Physician 1998;58:1811-20.

Contact Information

Chemistry - Downtown: (315)464-4460
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