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HelpEpic Code LAB12300450 Amikacin, Peak, Serum
Additional Codes
Mayo Code: PAMIK
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Monitoring adequacy of serum concentration during amikacin therapy
Specimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
Day(s) Performed
Monday through Sunday
Reference Values
Peak: 20.0-35.0 mcg/mL
Toxic peak: >40.0 mcg/mL
Clinical Information
Amikacin is an aminoglycoside used to treat severe blood infections by susceptible strains of gram-negative bacteria. Aminoglycosides induce bacterial death by irreversibly binding bacterial ribosomes to inhibit protein synthesis. Amikacin is minimally absorbed from the gastrointestinal tract, and thus can been used orally to reduce intestinal flora.
Peak serum concentrations are seen 30 minutes after intravenous infusion, or 60 minutes after intramuscular administration. Serum half-lives in patients with normal renal function are generally 2 to 3 hours. Excretion of aminoglycosides is principally renal, and all aminoglycosides may accumulate in the kidney at 50 to 100 times the serum concentration.
Toxicity can present as 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.
Cautions
Aminoglycosides are excreted primarily by glomerular filtration, thus, the serum half-life will be prolonged and significant accumulation will occur in patients with impaired renal function.
Interpretation
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 >35.0 mcg/mL for a prolonged period of time.
Reporting Name
Amikacin, Peak, SMethod Name
Kinetic Interaction of Microparticles in Solution (KIMS)
Method Description
Kinetic interaction of microparticles in solution (KIMS) as measured by changes in light transmission.
The assay is a homogeneous immunoassay based on the principle of measuring changes in scattered light or absorbance which result when activated microparticles aggregate. The microparticles are coated with amikacin and rapidly aggregate in the presence of an amikacin antibody solution. When a sample containing amikacin is introduced, the aggregation reaction is partially inhibited, slowing the rate of the aggregation process. Antibody bound to sample drug is no longer available to promote microparticle aggregation, and subsequent particle lattice formation is inhibited. Thus, a classic inhibition curve with respect to amikacin concentration is obtained, with the maximum rate of aggregation at the lowest amikacin concentration. By monitoring the change in scattered light or absorbance, a concentration-dependent curve is obtained.(Package insert: Roche Amikacin reagent, Roche Diagnostic Corp, Indianapolis, IN)
CPT Code Information
80150
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PAMIK | Amikacin, Peak, S | 3319-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| PAMIK | Amikacin, Peak, S | 3319-1 |
Report Available
Same day/1 dayTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.Clinical Reference
1. Wilson JW, Estes LL: Mayo Clinic Antimicrobial Therapy Quick Guide, 2008
2. Hammett-Stabler CA, Johns T: Laboratory guidelines for monitoring of antimicrobial drugs. national academy of clinical biochemistry. Clin Chem 1998 May;44(5):1129-1140
3. Gonzalez LS III, Spencer JP: Aminoglcosides: a practical review. Am Fam Physician 1998 Nov 15;58(8):1811-1820
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.