Acetaminophen


Abbrev Code:ACETA   
Order Code:LAB43Order Name:Acetaminophen Level
Synonyms:Tylenol
Methodology:Roche: Homogenous enzyme immunoassay
Woodwinds: Enzymatic/colorimetric
CPT Codes: 80143 x1, 80143 x1
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.
Associated Links:

Roche Go Live Schedule


Collection Instructions

Specimen:Blood
Optimal Volume:2.5 mL
Minimum\Peds Volume:0.6 mL
Collection Instructions:Chemistry Tests Containers Chart
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.
Stability:Roche: 7 days capped refrigerated; 6 months capped frozen.
Test Performed at or Referral Lab Chemistry  (Roche-Grand Itasca, Roche-Lakes, Roche-Northland, Roche-Range, Roche-Ridges, Roche-Southdale, Roche-St. John's, Roche-UMMC East, Roche-UMMC West, Woodwinds)


Interpretive

Critical Range:All other sites: Greater than 150 mg/L
Woodwinds: >120 mg/L
Therapeutic Range:All other sites: 10-30 mg/L
Woodwinds: 10-20 mg/L
Limitations:
  • Samples processed on the Vista platform with an icterus index level of 2-5 (bilirubin level of 3-20 mg/dL)  are sent to UMMC East Core for testing on the Roche platform.
  • Samples processed on the Vista platform with an icterus index level of ≥6 (bilirubin level of >20 mg/dL) are sent to MedTox for testing (LAB6710).
  • Samples processed on the Roche platform with an bilirubin level of >30 mg/dL are sent to MedTox for testing (LAB6710).
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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