Acetaminophen


Sunquest Code:ACETA  
Epic Code:LAB43Epic Name:Acetaminophen Level
Synonyms:Tylenol
Methodology:Bichromatic end point
Grand Itasca: Homogenous enzyme immunoassay
St. Johns/Woodwinds: Enzymatic/colorimetric
Turnaround Time:Performed and reported 24 hours/day.
Special Instructions:Samples with elevated bilirubin may be sent to MedTox for additional testing. See Acetaminophen to MedTox for additional information.


Collection Instructions

Specimen:Blood
Optimal Volume:2.5 mL
Minimum\Peds Volume:0.6 mL
Container:Red (no gel), St Johns/St Joseph/Woodwinds - Red (no gel) (Green (lithium heparin, gel), Green (lithium heparin) on ICE, Red or gold (gel), St Johns/St Joseph/Woodwinds-Green (lithium heparin, no gel))
Collection Instructions:If ingestion time is known, collect no sooner than four hours after ingestion (peak level). If time of ingestion is not known, determine half-life by collecting two levels 2-3 hours apart.


Processing and Shipping

Specimen Processing:Centrifuge and transfer serum/plasma within 2 hours of collection. Aliquot 1.25 mL, 0.2 mL minimum. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Test Performed at or Referral Lab Chemistry  (Range, UMMC-East Bank, Lakes, Ridges, Northland, Southdale, UMMC/UMMCH-West Bank, Grand Itasca, St. John's, Woodwinds)


Interpretive

Critical Range:Greater than 150 mg/L
GH: >100 ug/mL
SJO/SJN/WW: >120 mg/L
Therapeutic Range:10-30 mg/l
SJO/SJN/WW: 010-20 mg/L
Use:Evaluate toxicity. Half life is 1-3 hours. Half-life or absolute concentration may be used to judge potential toxicity. If serum half-life is >4h, toxic liver damage is probable. Concentrations >200 mg/L at 4 hours after ingestion or >50 mg/L at 12 hours after ingestion are likely to cause liver damage, and treatment with N-acetylcysteine is indicated. For other acetaminophen concentrations refer to Rumack-Mattew nomogram (Pediatrics 1975, 55:871-876).


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