Tricyclic Multi-Drug Screen

Label Mnemonic:	TADID
Epic code:	LAB7285
Downtime form:	A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

Plasma

Specimen Instructions:

Timing of specimen collection: Pre-dose (trough) draw - At steady- state concentration.

Collection Medium:

Lavender top tube 3 mL (EDTA)

Minimum:

Preferred Minimum: 1 mL plasma
Absolute Minimum: 0.5 mL plasma

Rejection Criteria:

Whole blood. Gel separator tubes, light blue (citrate), or yellow (SPS or ACD solution).

Turn Around Time:

1-5 days upon receipt at reference laboratory.

Reference Range:

Drug                                 Therapeutic Range       Toxic
Amitriptyline (Elavil, Vanatrip)      Not established   Not established
Nortriptyline (Aventyl, Pamelor)       50-150 ng/mL       > 500 ng/mL
Total Amitriptyline + Nortriptyline    95-250 ng/mL       > 500 ng/mL

Imipramine (Tofranil)                 Not established   Not established
Desipramine (Norpramin)                100-300 ng/mL      > 500 ng/mL
Total Imipramine + Desipramine         150-300 ng/mL      > 500 ng/mL

Doxepin (Sinequan, Zonalon)           Not established   Not established
Nordoxepin                            Not established   Not established
Total Doxepin + Nordoxepin             100-300 ng/mL      > 500 ng/mL

Protriptyline (Vivactil)                70-240 ng/mL      > 400 ng/mL

Clomipramine (Anafranil)              Not established   Not established
Norclomipramine                       Not established   Not established
Total Clomipramine + Norclomipramine   220-500 ng/mL      > 900 ng/mL

Comments:

Note: This test is used to quantitate the following tricyclic antidepressants: amitriptyline, clomipramine, desipramine, doxepin, imipramine, norclomipramine, nordoxepin, nortriptyline, and protriptyline.

Methodology:

Quantitative Liquid Chromatography-Tandem Mass Spectrometry

CPT Code:

80335