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Epic Test Code LAB23 Digoxin

Performing Location(s)

MIB,CRH,LFH,OCH,FTT

Synonyms

Lanoxin

Includes

Quantitative analysis for Digoxin

Specimen Type

Serum or Plasma

Preferred Container

Gold or Red top tube

Alternate Container

Green top tube

Minumum Volume to Submit for Testing

0.5 mL Serum/Plasma

  • Multiple test can be performed from this volume. For question please contact the lab at 547-3975.  

Storage Requirements

Centrifuge and separate serum from cells within 2 hours of collection

Specimens may be kept at room temperature, tightly capped for up to 8 hours

If the assay will not be completed within 8 hours, refrigerated the serum at 2-8° Celsius

Transportation Needs

Deliver specimen to the laboratory within 1 hour of collection. If not possible see “storage requirements”

Causes for Rejection

Mislabeled or unlabeled specimen

Less than 50% draw for Vacutainer tubes

Serum > 3 days refrigerated

Plasma > 24 hours

Days of Analysis

All

Additional Information

Collection Guideline:

Monitor after patient reaches steady state and at least 8 hours after last dose. The serum concentration does not correlate with pharmacologic activity untli the post distribution period (at least 8-12 hours after last dose)

Limitations

Endogenous, digoxin-like immunoreactive factors (DLIF) have been detected in the serum and plasma of neonates, pregnant women, and patients in renal and hepatic failure. Several studies have established that these factors can cause falsely elevated digoxin measurements when assayed by commercially available immunoassays.

Digoxin bound to Fab fragments of antidigoxin antibodies, as found in serum and plasma of individuals being treated for digoxin toxicity, may result in misleading digoxin values.

 

Patients taking biotin supplements in excess of the daily recommended allowance may cause falsely elevated results.

 

The following substances have been shown to cross-react with the DIGXN method:

 

Substance Digoxin Level Tested
ng/mL [nmol/L]
Cross Reactivity
%
Acetyldigitoxin (25 ng/mL) 0 [0]
2.00 [2.56]
14
10
Deslanoside (2.5 ng/mL) 0 [0]
2.00 [2.56]
56
63
Digitoxin (25 ng/mL) 0 [0]
2.00 [2.56]
13
10
Digoxigenin (5 ng/mL) 0 [0]
2.00 [2.56]
8
-9
Digoxigenin bis-digitoxoside (2.5 ng/mL) 0 [0]
2.00 [2.56]
96
94
Digoxigenin mono-digitoxoside (2.5 ng/mL) 0 [0]
2.00 [2.56]
59
52
Dihydrodigoxin (25 ng/mL) 0 [0]
2.00 [2.56]
2
-3
Gitoxin (25 ng/mL) 0 [0]
2.00 [2.56]
0
-1
Lanatoside C (1.5 ng/mL) 0 [0]
2.00 [2.56]
59
70

 

Available STAT

Yes

Methodology

Homogeneous, sequential, chemiluminescent Immunoassay

Reference Values

Population Units Therapeutic Range High Critical Value
All populations ng/mL 0.8 - 2.0 > 2.4

 

CPT Code

80162

Last Updated

16-Apr-18