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Amiodarone is a class III antiarrhythmic agent approved for the treatment of life-threatening ventricular tachyarrhythmias. Because of potential toxicity the serum level of this drug should be monitored.1 Its major elimination is by hepatic excretion. Negligible renal excretion occurs. Use of the drug is restricted because of its many side effects, including pulmonary fibrosis, neuromuscular weakness, exacerbation of congestive heart failure, tremor, thyroid dysfunction, and interaction with other drugs. Potassium or magnesium deficiency should be corrected. AST and ALT should be monitored.
Liquid chromatography/tandem mass spectrometry (LC/MS-MS)
Therapeutic: amiodarone: 1.0−2.5 μg/mL, noramiodarone: 1.0−2.5 μg/mL
Absorption of amiodarone is slow and variable. During long-term treatment, the active desmethyl metabolite accumulates in plasma and the myocardium, and concentrations may exceed that of the parent compound.
Serum or plasma
Red-top tube, lavender-top (EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.
Transfer separated serum or plasma to a plastic transport tube before freezing.
Causes for Rejection
Gel-barrier tube; specimen not frozen
|Order Code||Order Code Name||Order Loinc||Result Code||Result Code Name||UofM||Result LOINC|
|706705||Amiodarone (Cordarone(R)), S||706713||Amiodarone, Serum||ug/mL||3330-8|
|706705||Amiodarone (Cordarone(R)), S||706721||Noramiodarone,S||ug/mL||6774-4|