Digoxin Level


Abbrev Code:DIGX   
Order Code:LAB23Order Name:Digoxin Level
Synonyms:Lanoxin Level; DIGX
Methodology:Roche: Competitive test principle using a monoclonal antibody
Grand Itasca: Homogenous enzyme immunoassay
Woodwinds: Chemiluminescent microparticle immunoassay (CMIA)
Vista: Turbidmetric rate
CPT Codes: 80162 x1, 80162 x1
Turnaround Time:Performed and reported 24 hours/day.
Special Instructions:Elevated results may occur if blood is collected less then 6 hours after last dose.
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
Collect a minimum of 6 hours after last dose.
Causes for Rejection:Gross hemolysis; collected less than 6 hours post dose.
Contraindications:Do not order level if patient is on digitoxin or any other cardiac glycoside.


Processing and Shipping

Specimen Processing:Centrifuge and aliquot within 2 hours of collection 1.25 mL, 0.2 mL minimum. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Stability:Roche: 7 days at room temperature; 14 days refrigerated; 6 months frozen (freeze only once).
Vista: 8 hours at room temperature; 7 days refrigerated; 6 months frozen. 
Test Performed at or Referral Lab Chemistry  (Grand Itasca, Northland, Range, Roche-Lakes, Roche-Ridges, Roche-St. John's, Roche-UMMC East, Southdale, UMMC/UMMCH-West Bank, Woodwinds)


Interpretive

Critical Range:Greater than 2.5 ug/L
Toxicity of digoxin may reflect several factors:
  1. The drug has a low therapeutic ratio (i.e. a very small difference exists between therapeutic and toxic tissue levels.
  2. Individuals vary in their response to digoxin.
  3. Absorption of various tablet forms of digoxin may vary over a two-fold range.
  4. Susceptibility to digitalis toxicity apparently increases with age mainly associated with renal impairment.
Therapeutic Range:All ages: 0.6-2.0 ug/L.
The reference range for infants (0-2 mo) is thought to be closer to 3.0-4.0 ug/L; infants tolerate more digoxin because they have more binding sites and an increased metabolic rate.
Use:Monitor therapeutic dosing and evaluate toxicity. Half-life is 36-44 h (adult); 12-24 h (child); 18-33 h (infant); and 35-88 h (neonate).


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