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HelpTest Code LAB304 Theophylline, Plasma or Serum
Additional Codes
| Test Name in EPIC | EPIC Test Code | Mnemonic |
|---|---|---|
| THEOPHYLLINE | LAB304 | THEO |
Methodology
Chemiluminescent Microparticle Immunoassay (CMIA)
Specimen Requirements
Draw specimens according to following schedule:
| Oral Loading Dose | Draw Time |
| NICU | 4 hours post dose |
| PICU (liquid oral) | 2 hours post dose |
| PICU (oral tablet/capsule) | 3 to 4 hours post dose |
| Adult (liquid [fast release] or sustained release tablet/ capsule: routine therapeutic monitoring) | draw a trough level |
| Adult (peak level) | 4 to 8 hours post dose |
| Intravenous Loading Dose | Draw Time |
| NICU | 4 hours after dose is infused |
| Adult | 4 to 8 hours after start of infusion or rate changes* |
| *A level may need to be drawn 30 minutes after loading dose to see if additional loading dose is needed. | |
| If toxicity is suspected, draw level when ordered STAT. | |
Specimen must be refrigerated until test is performed.
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Plasma
Container/Tube: Light-green top (lithium heparin gel)
Specimen Volume: 1 mL
Specimen Minimum Volume: 0.5 mL
Collection Instructions: Hemolyzed specimen is not acceptable. Spin down, separate plasma from cells within 2 hours of draw.
Additional Information:
1. Avoid repeated freeze/thaw cycles.
2. If extreme lipemia-use ultracentrifuged specimen.
3. Label specimen appropriately (plasma).
Alternate:
Specimen Type: Serum
Container/Tube: Serum gel
Specimen Volume: 1 mL
Specimen Minimum Volume: 0.5 mL
Collection Instructions: Hemolyzed specimen is not acceptable. Spin down, separate serum from cells within 2 hours of draw.
Additional Information:
1. Avoid repeated freeze/thaw cycles.
2. If extreme lipemia-use ultracentrifuged specimen.
3. Label specimen appropriately (serum).
Specimen Transport Temperature
Refrigerate 5 days /Frozen OK/Ambient 48 hours OK
Day(s) Test Set Up
Monday through Sunday
Performing Laboratory
Chemistry-
East Region: SMDC Clinical Lab
West Region: Fargo Hospital Lab
Test Classification and CPT Coding
80198
Reference Values
10-20 µg/mL