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Epic Test Code LAB3828 Pentobarbital, Serum

Additional Codes

MML Code: PENTS

LIS Code: PNTO

NY State Approved

Yes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Reporting Name

Pentobarbital, S

Method Name

Gas Chromatography Mass Spectrometry (GC-MS)

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days


Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Red top (Serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions:

1. Draw blood immediately before next scheduled dose.

2. Centrifuge and aliquot serum in plastic vial within 2 hours of collection.


Specimen Type

Serum Red

Specimen Minimum Volume

0.7 mL

Reference Values

Therapeutic range

Hypnotic: 1-5 mcg/mL

Therapeutic coma: 20-50 mcg/mL

Reducing intracranial pressure: 30-40 mcg/mL

This degree of sedation requires artificial respiratory support.

Toxic concentration: >10 mcg/mL

Report Available

3 to 9 days

Day(s) Performed

Thursday

CPT Code Information

80299

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross icterus OK

Useful For

Monitoring of pentobarbital therapy treatment

Clinical Information

Pentobarbital is a short-acting barbiturate with anticonvulsant and sedative-hypnotic properties. Uses include sedation induction, relief of preoperative anxiety, control of status epilepticus or seizures resulting from meningitis, tetanus, alcohol withdrawal, poisons, chorea, or eclampsia, and induction of coma in the management of cerebral ischemia and increased intracranial pressure that may follow stroke or head trauma.(1,2)

 

Pentobarbital is administered orally, parenterally, and rectally. The duration of hypnotic effect is about 1 to 4 hours. The drug distributes throughout the body with about 35% to 45% of a dose bound to plasma proteins in the blood. Metabolism takes place in the liver via oxidation to the inactive metabolite, hydroxypentobarbital. Elimination is biphasic; half-life is about 4 hours in the first phase, and 35 to 50 hours in the second phase. Excretion occurs through the urine, mainly as glucuronide conjugates of metabolites, with only about 1% excreted as unchanged drug.(1,2) Tolerance to the hypnotic effects of pentobarbital occurs after about 2 weeks of continuous dosing.

Interpretation

Pentobarbital concentrations above 10 mcg/mL have been associated with toxicity.

Specimen Retention Time

14 days

Cautions

The concentration at which toxicity occurs varies and results should be interpreted in light of clinical situation.

 

Specimens collected in serum gel tubes are not acceptable because the drug can absorb on the gel and lead to falsely decreased concentrations.

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.