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Chlordiazepoxide and metabolites; demoxepam; N-desmethylchlordiazepoxide; N-desmethyldiazepam
Evaluate toxicity; monitor therapeutic levels
Liquid chromatography/tandem mass spectrometry (LC/MS-MS)
This drug is commonly used in suicide attempts. Chlordiazepoxide is slowly absorbed and may take several hours to reach a peak plasma level. Distribution after intramuscular administration is poor. Drug half-life in blood ranges from 16 to 27 hours. The drug is highly (90%) protein bound. Overdosage with the benzodiazepines is frequent, but serious sequelae are rare; however, there is an additive effect when used with other CNS depressants (eg, ethanol). If a patient is comatose after a drug ingestion, chlordiazepoxide alone is not a sufficient explanation. Metabolism results in the production of four active metabolites. This drug is used as an antianxiety agent for treatment of withdrawal symptoms of acute alcoholism.
Half-life elimination: 6.9 to 28 hours
Time to peak: 0.5 to 2 hours
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. Oral: peak: four hours; trough: immediately prior to next dose.
Causes for Rejection
|Order Code||Order Code Name||Order Loinc||Result Code||Result Code Name||UofM||Result LOINC|
|007682||Chlordiazepoxide, Serum||019661||Chlordiazepoxide, S||ug/mL||3457-9|
|007682||Chlordiazepoxide, Serum||019687||Nordiazepam, Serum||ug/mL||3537-8|
|007682||Chlordiazepoxide, Serum||019689||Sum of Metabolites||ug/mL||33060-5|