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Akron Children's > For Healthcare Professionals > Lab Tests : Akron | Mahoning Valley

Phenobarbital

PATIENT INFO
Patient Name:
Medical Record #:
BD:       /      /         Sex:   F   M

PHYSICIAN INFO
Physician Name :
Address:
Ph: (      )      -          Fax: (      )      -       
Additional Report to:
Ph: (      )      -          Fax: (      )      -       

TESTS REQUESTED
Test Name: ICD9 Code: (required)
1. Phenobarbital  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
PHNO
Test Workstation :
ACHM5
Specimen Type:
Blood
Tube Type:
Green top (lithium heparin) tube
Minimum Volume:
500 uL
Preferred Volume:
1.5 mL
Storage:
Shipping: Send Refrigerated; Storage-Refrigerated: 7 days; Frozen: 1 year
Availability:
24 hours/day, 7 days/week
Methodology:
Roche: Molybdate UV
Special Instructions:
For therapeutic monitoring, draw peak levels 2 hours postIV injection or 12 hours postoral ingestion and trough levels immediately prior to next dose.
Lab/Phone:
330-543-8418
TAT:
1 hour
Additional Info:
Therapeutic range: 15-40 ug/mL
CPT Code:
80184

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