Flecainide
| 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. Flecainide | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
FLEC
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Alternate Tube Type:
EDTA-Lav
Collection Volume:
5.0 mL
Minimum Volume:
1.5 mL
Cause for Rejection:
Collected in serum separator tube or gels of any kind
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Quantitative Liquid Chromatography - Tandem Mass Spectrometry
Special Instructions:
Do not use serum separator tubes. Remove serum from cells within 6 hours of collection and transfer into standard aliquot tube.
Predose(trough) draw at steady state concentration.
If collected at an offsite location, send by a STAT Courier to Hospital lab
Lab/Phone:
330-543-8418
TAT:
2-9 days
Additional Info:
Reference range: 0.20-1.00 mcg/mL
Toxic: >1.50 mcg/mL
CPT Code:
80181
Synonyms:
Almarytm; Apocard; Ecrinal; Tambocor
